Medical Terminology Daily (MTD) is a blog sponsored by Clinical Anatomy Associates, Inc. as a service to the medical community, medical students, and the medical industry. We post anatomical, medical or surgical terms, their meaning and usage, as well as biographical notes on anatomists, surgeons, and researchers through the ages. Be warned that some of the images used depict human anatomical specimens.

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A Moment in History

Self-portrait, Henry Vandyke Carter, MD (Public Domain)
Self-portrait, Henry Vandyke Carter, MD (Public Domain)

Henry Vandyke Carter, MD
(1831 – 1897)

English physician, surgeon, medical artist, and a pioneer in leprosy and mycetoma studies.  HV Carter was born in Yorkshire in 1831. He was the son of Henry Barlow Carter, a well-known artist and it is possible that he honed his natural talents with his father. His mother picked his middle name after a famous painter, Anthony Van Dyck. This is probably why his name is sometimes shown as Henry Van Dyke Carter, although the most common presentation of his middle name is Vandyke.

Having problems to finance his medical studies, HV Carter trained as an apothecary and later as an anatomical demonstrator at St. George’s Hospital in London, where he met Henry Gray (1872-1861), who was at the time the anatomical lecturer. Having seen the quality of HV Carter’s drawings, Henry Gray teamed with him to produce one of the most popular and longer-lived anatomy books in history: “Gray’s Anatomy”, which was first published in late 1857.  The book itself, about which many papers have been written, was immediately accepted and praised because of the clarity of the text as well as the incredible drawings of Henry Vandyke Carter.

While working on the book’s drawings, HV Carter continued his studies and received his MD in 1856.

In spite of initially being offered a co-authorship of the book, Dr. Carter was relegated to the position of illustrator by Henry Gray and never saw the royalties that the book could have generated for him. For all his work and dedication, Dr. Carter only received a one-time payment of 150 pounds. Dr.  Carter never worked again with Gray, who died of smallpox only a few years later.

Frustrated, Dr. Carter took the exams for the India Medical Service.  In 1858 he joined as an Assistant Surgeon and later became a professor of anatomy and physiology. Even later he served as a Civil Surgeon. During his tenure with the India Medical Service he attained the ranks of Surgeon, Surgeon-Major, Surgeon-Lieutenant-Colonel, and Brigade-Surgeon.

Dr. Carter dedicated the rest of his life to the study of leprosy, and other ailments typical of India at that time. He held several important offices, including that of Dean of the Medical School of the University of Bombay. In 1890, after his retirement, he was appointed Honorary Physician to the Queen.

Dr. Henry Vandyke Carter died of tuberculosis in 1897.

Personal note: Had history been different, this famous book would have been called “Gray and Carter’s Anatomy” and Dr. Carter never gone to India. His legacy is still seen in the images of the thousands of copies of “Gray’s Anatomy” throughout the world and the many reproductions of his work available on the Internet. We are proud to use some of his images in this blog. The image accompanying this article is a self-portrait of Dr. Carter. Click on the image for a larger depiction. Dr. Miranda

1. “Obituary: Henry Vandyke Carter” Br Med J (1897);1:1256-7
2. “The Anatomist: A True Story of ‘Gray’s Anatomy” Hayes W. (2007) USA: Ballantine
3. “A Glimpse of Our Past: Henry Gray’s Anatomy” Pearce, JMS. J Clin Anat (2009) 22:291–295
4. “Henry Gray and Henry Vandyke Carter: Creators of a famous textbook” Roberts S. J Med Biogr (2000) 8:206–212.
5. “Henry Vandyke Carter and his meritorious works in India” Tappa, DM et al. Indian J Dermatol Venereol Leprol (2011) 77:101-3

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Sulcus / gyrus

These two different terms must be analyzed together. The Latin term [sulcus] means "groove or fissure". Its plural form is [sulci]. There are many anatomical sulci in the body, one of them being the costal sulcus in the ribs.

The second term [gyrus] is also Latin and means "circle or ring", as used in the words gyroscope or gyrations. In its adjective or descriptive form, [gyrus] is used to denote something "bent, curved, or broad-shouldered"1. The plural form is [gyri]. In the case of the brain a gyrus is formed as a mound or an elevation between the "valleys" of the sulci (see image). If you click on the image a secondary image depicting the lateral aspect of the brain will appear.

In the brain there are many sulci, the secondary image shows the lateral or Sylvian sulcus, and the central sulcus or sulcus of Rolando.

Sulcus / gyrus and Brain, lateral view (www.bartleby.com)
In relation to the central sulcus there are two gyri. The anteriorly situated precentral gyrus is considered the primary motor cortex and associated with voluntary motor activity (colored in green in the secondary image).  The postcentral gyrus (colored in blue) is situated posterior to the central sulcus and is the primary sensory cortex, associated with somatic (bodily) conscious sensation. 

"The origin of Medical Terms" Skinner, AH, 1970
Initial image by: Albert Kok, courtesy of: Wikipedia.org. Secondary image modified from the original. 
Additional information courtesy of Bartleby.com.
Terms suggested by Sara Mueller.  

Adam Christian Thebesius

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.To search all the articles in this series, click here.

Adam Christian Thebesius (1686- 1732). German physician and anatomist, Thebesius studied in the University of Leiden, Netherlands, where he received his doctorate in 1708 with the thesis "De circulo sanguinis in corde" (on the circulation of the blood in the heart). In 1713 he became a member of the Royal Academy of Natural Scientists (Kaiserliche Akademie der Naturforscher), where he adopted the Latin name "Eyryphon". Besides his natural sciences and medical research, Thebesius developed an interest in astrophysics.

Extremely interested in coronary circulation, Thebesius injected dyes and fluids in the coronary arteries, veins, and coronary sinus. Along with Raymond Vieussens (1635-1713) , Thebesius described all these structures. Today his name is attached to the eponymic Thebesian veins (venae cordi minima), and the Thebesian valve guarding the exit of the coronary sinus into the right atrium of the heart. Both these structures were mentioned in his 1708 doctoral thesis

1. “The Role of the Thebesian Vessels in the Circulation of the Heart” Wearn, J.T. J Exp Med. 1928 January 31; 47(2): 293–315
2. The Story Behind the Word. Some Interesting Origins of Medical Terms. Wain,H. 1958. 
3. The Origin of Medical Terms. Skinner, H.A. 1970

Adam Christian Thebesius

Original image courtesy of Images from the History of Medicine at nih.gov

Ventricular system of the brain

The ventricular system of the brain is an interconnected system of cavities and ducts within the brain through which cerebrospinal fluid (CSF) circulates. The CSF is produced in the choroid plexuses located within the ventricles.

There are two large curved lateral ventricles, each found within a cerebral hemisphere. They connect with the third ventricle via an opening called the "foramen of Monro". The third ventricle connects with the fourth ventricle by way of a slender canal called the "cerebral aqueduct" or the "aqueduct of Sylvius".

The third ventricle is found deep within the brain between the right and left diencephalic portion of the cerebrum.

The fourth ventricle is located between the pons of the brain stem anteriorly and the cerebellum posteriorly. This ventricle has a rhomboidal shape and it connects with the external aspect of the brain and the subarachnoid space. Failure of this CSF drainage from the ventricles to the subarachnoid space can lead to pathological accumulation of CSF within the ventricles and hydrocephalus.

The superior image shows a lateral view of the brain with a superimposed image of the ventricular system. If you click on this image, you will see a superior view of a cast of the ventricular system (by Retzius). More information on these images at www.bartleby.com.

The inferior image shows a posterior view of the brain stem and the cerebellum which has been opened in the median plane to expose the 4th ventricle. Click on the image to see a larger version.

Ventricular system of the brain (www.bartleby.com)
Superior image courtesy of: www.bartleby.com
4th ventricle - Human brain dissectionInferior image property of: CAA.Inc.
Photographer: Efrain Klein

Cerebrospinal fluid

The cerebrospinal fluid (CSF) is a colorless, transparent fluid produced from the arterial flow of blood by the choroid plexuses found within the ventricular system of the brain. The CSF exits the ventricular system and enters the subarachnoid space and its cisterns. It is then absorbed at the level of the arachnoid granulations into the venous component of the cardiovascular system.

The CSF has many functions, some of them being protection, the creation of a fluid environment where the brain 'floats", cleansing, and others. For a more detailed description of the CSF, click here.

The CSF is produced at an average rate of 550-700ml/day. It is absorbed at the same rate. An imbalance between production and absorption of CSF (as well as a blockage within the ventricular system) can lead to an accumulation of CSF within the brain, causing hydrocephalus.

Hippocrates of Cos

This article is part of the series "A Moment in History" where we honor those who have contributed to the growth of medical knowledge in the areas of anatomy, medicine, surgery, and medical research.To search all the articles in this series, click here.

Hippocrates of Cos (460 BC - 370 BC). A Greek physician, Hippocrates was born on the Greek island of Cos (Kos) c. 460BC. Considered the "Father of Medicine" he removed Medicine from the realms of superstition and magic. He was the first to record medical writings and is considered the first one to use and maintain proper medical terminology. There are many writing attributed to Hippocrates, but there is no assurance that these were actually written by Hippocrates himself. Hippocrates changed the art of medical diagnosis by replacing supernatural precepts with observation-based methodology. Natural, rather than supernatural causes, would from here on explain all disease processes, what was known as Rational Medicine.

He is known for having set the oath that governs medical principles, the Hippocratic Oath, although there are many authors that contend that this oath was written long time after he died.

1. "Hippocrates himself" JAMA. 1968;204(12):1138-1139

2. "Hippocrates: father of medicine" Tan, S Y (01/01/2002). Singapore medical journal(0037-5675), 43(1), p.5.

Original image courtesy of  www.nih.gov

Atrioventricular sulcus

This is a combined word arising from terms [atrium], [ventricle], and [sulcus]. For the etymology of each word, click on the corresponding link.

The atrioventricular sulcus, also know as the "coronary groove" or "coronary sulcus" is an evident incomplete groove between the atria and ventricles of the heart. It is complete posteriorly and is separated anterosuperiorly by the roots of the aorta and the pulmonary trunk.  It contains the right coronary artery on the right side, and the circumflex artery on the left side, hence the name "coronary groove". These coronary arteries are not visible as they are usually covered by subepicardial fat.

The atrioventricular sulcus (and the corresponding coronaries) are also in relation to the deeper situated atrioventricular (AV) valves, the tricuspid valve on the right; and the mitral or bicuspid valve on the left side. The accompanying image depicts the location of the AV valves, and therefore the location of the AV sulcus.

Source: "Gray's Anatomy"38th British Ed. Churchill Livingstone 1995

Anterior view of the thorax, showing surface relations of bones, lungs (purple), pleura (blue), and heart (red outline). P. Pulmonary valve. A. Aortic valve. B. Bicuspid valve. T. Tricuspid valve (www.bartleby.com)

Images courtesy of www.bartleby.com 
Click on the image for a larger version.
Anterior view of the thorax, showing surface relations of bones, lungs (purple), pleura (blue), and heart (red outline). P. Pulmonary valve. A. Aortic valve. B. Bicuspid valve. T. Tricuspid valve